5Q: Christopher Ferraro | Chief financial officer, Coastal Medical Inc.
1. Coastal Medical has operated as an accountable care organization since 2012. What led to that business model? ACOs were created under the Affordable Care Act with a focus on the triple aim: better health, better care at a lower cost for patients. These core components aligned with Coastal’s values as an organization and our business strategy. Coastal was able to utilize the foundation built as a patient-centered medical home to transition into accountable care. Blue Cross & Blue Shield of Rhode Island was our first ACO agreement. … We are now responsible for managing the care of patients under seven different ACO contracts.
2. What are the most significant changes that Coastal has made related to taking on the ACO contract with Medicare? We’ve been able to take care to a nationally recognized level by providing services such as urgent primary care visits, chronic-disease care management programs and follow-up phone calls after discharge from the emergency room and hospital. Many of our services are unique to Coastal and have allowed us to reduce the total Medicare cost ... by $74 million and earn shared savings [for the company] of $32 million over a five-year period [2013-2017].
3. The final numbers aren’t in yet, but how do you expect 2018’s results to compare with past performance? We expect our 2018 results to be consistent with our high performance as an ACO in past years. We averaged a 97.5% quality score in the Medicare Shared Savings Program from 2013-2017. We are also in the process of renewing our participation as a Medicare ACO and becoming a Medicaid Accountable Entity.
4. Would Medicare-for-all affect how Coastal Medical operates? In 2011, we took a strategic leap of faith and went all in on making accountable care a sustainable business model. Medicare-for-all means different things to different people. We will remain on our path of delivering high-quality, high-value care for patients.
5. Are you making any changes to comply with Rhode Island’s targeted growth of 3.2% in health care spending through 2022? Our president and CEO, Dr. Al Kurose, is a co-chair of the R.I. Health Care Cost Trends Steering Committee, convened by Gov. Gina M. Raimondo, that is leading the efforts to control the cost of health care in the state.
Elizabeth Graham is a PBN staff writer. Contact her at Graham@PBN.com.
